Individual provider Active NPI

Jeffrey William Garcia, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • San Luis Obispo, CA
National Provider Identifier
1407113228
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
62013 Issued in CA
Practice address
683 California Blvd
San Luis Obispo, CA 93401-2580
Phone
(310) 975-5090
NPI assigned
Apr 18, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 62013 CA Primary

Addresses

Primary practice location

683 California Blvd
San Luis Obispo, CA 93401-2580

Mailing address

683 California Blvd
San Luis Obispo, CA 93401-2580
Phone (310) 975-5090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171228002826 CA Practitioner - Oral SurgeryPractitioner - Plastic and Reconstructive Surgery 2860750585 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
62013CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Associates Corporation CurrentSince Oct 14, 2017 Accepting new patients
Salomone & Bass, DDS, Apc Oral and Maxillofacial Surgery Past Accepting new patients

Locations

1150 N Indian Canyon Dr
Palm Springs, CA 92262
Phone (760) 323-6251

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1407113228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "683 CALIFORNIA BLVD",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012580",
            "telephone_number": "310-975-5090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "683 CALIFORNIA BLVD",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012580",
            "telephone_number": "310-975-5090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "JEFFREY",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-18",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "62013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.